Abstract: Objective To explore the evaluation of left-ventricular diastolic function by transesophageal speckle tracking echocardiography after revascularization in the elderly patients undergoing off-pump coronary artery bypass grafting (off-pump CABG). Methods A total of 49 elderly patients undergoing off-pump CABG were recruited. Transesophageal echocardiography examination was performed at T₀ (5 min after placement of the transesophageal echocardiography probe) and T₁ (30 min after revascularization). The four-, two-, and three-chamber views were obtained for 3 cardiac cycles, and then copied to a Philips QLab workstation. Strain rate during isovolumic relaxation (SR_IVR), strain rate during early diastole (SRe) and strain rate during late diastole (SRa) were analyzed. The changes of left-ventricular diastolic function after coronary revascularization were compared. The correlation between strain rate-based indices (SBIs) and pulmonary capillary wedge pressure (PCWP) was analyzed,and the predictive ability of SR_IVR,SRe and SRa for the increase of PCWP was also evaluated. Results SR_IVR and SRa were significanly improved after revascularization (both P＜0.05). At T₀ and T₁, SR_IVR was negatively correlated with PCWP (r=-0.78, -0.72,all P＜0.001). At T₀ and T₁, SR_IVR showed a strong ability to predict PCWP ≥ 12 mmHg (AUC=0.88, 0.89). Conclusions Strain based indices were more sensitive and accurate predictors for the increase of PCWP, which has a good prospect in clinical application.

Key words: transesophageal echocardiography, speckle tracking imaging, off-pump coronary artery bypass graft, strain rate during isovolumic relaxation, aged